1. Field of the Invention
This invention concerns a medical instrument used to manipulate a uterus during laproscopic examination or surgery a method associated therewith, The instrument is designed to receive a manipulating element or tip which may be pivoted relative to the frame of the instrument by turning a handle, the device including a locking mechanism for holding the handle and thus the tip in a desired position,
2. Description of the Prior Art
Gynecologists frequently examine the internal pelvic organs of a patient by using a laparoscope. The medical procedures may include laproscopic tubal occlusion and fertility studies. During such laproscopic procedures, it is frequently necessary for the uterus to be repositioned in order to obtain an X-ray or to perform surgery.
Instruments have been developed to aid the surgical team in these procedures, and particularly to manipulate the uterus into a desired orientation. Typically, these instruments involve a tip or hook which is pivotally mounted on a frame and which can be manipulated by a handle of some type positioned remote from the tip. The devices are used by inserting the tip through the vaginal canal until reaching the uterus. With the tip engaging the uterus, medical personnel shift a handle or the like on the portion of the device then exterior to the patient's body, which in turn raises the uterus into position. Such devices are shown by, for example, U.S. Pat. Nos. 4,022,208 to Valtchev and 4,085,756 to Weaver.
More recently, a uterine manipulator has been developed which include a rotatable handle which serves to actuate and orient the tip of the device. Such an instrument with a rotatable handle is enjoying increased popularity, but has a disadvantage in that while it is provided with detents to audibly signal reorientation of the tip, the detents fail to engage with sufficient force to hold the tip, and therefore the uterus, in position. Consequently, a nurse or physician is compelled to hold the handle against undesired turning to prevent movement of the uterus, producing fatigue as well as preventing use of the hand for other tasks.
In addition, the task to be performed by such devices, while important, is mechanically fairly simple. In many instances, it may be more economical to provide a simplified device which may be inexpensively constructed and disposed of after use rather than undergoing rigorous sterilization procedures. Nonetheless, such disposable instruments nonetheless would preferably include some type of locking mechanism to prevent undesired movement of the handle connected to the tip.
A further observation which has been made about the current uterine manipulating devices is that they fail to provide a visually perceptible indication of the orientation of the tip and therefore the uterus relative to the remainder of the instrument. Since the tip is positioned entirely interior to the patient's body during use, it is often difficult or impossible for the physician to know, at a glance, the degree to which the uterus has been moved from the normal position. A need has therefore developed for a uterine manipulation device which includes a means for visually or tactilly perceiving the orientation of the tip by viewing the position of the handle relative to the frame.